CMS Formulary

Displaying 4251-4260 of 1611142 results.
ID: 4251
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 4252
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4253
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4254
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4255
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4256
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 4257
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4258
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4259
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4260
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0